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Semin Thromb Hemost 2000; 26(6): 605-618
DOI: 10.1055/s-2000-13216
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Fibrin Clot Formation and Lysis: Basic Mechanisms

Johannes J. Sidelmann1 , Jørgen Gram1 , Jørgen Jespersen, Cornelis Kluft1,2
  • 1From the Department for Thrombosis Research, University of Southern Denmark-Esbjerg, Denmark
  • 2The Gaubius Laboratory, TNO-PG, Leiden, The Netherlands
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

The hemostatic balance, introduced more than 40 years ago, addresses the components and reactions involved in fibrin turnover. Fibrin is placed in the core of this delicate balance. Defects in the mechanisms responsible for fibrin turnover might lead to thrombosis or bleeding, and fibrin consequently is an important substrate in the physiology of hemostasis.

This review describes the components and processes involved in fibrin formation and fibrin degradation. Particular emphasis is put on the reactions involved in the conversion of fibrinogen to fibrin, the polymerization of fibrin molecules induced by coagulation factor XIII (FXIII), and the degradation of fibrinogen and fibrin mediated by plasmin and elastase. Furthermore, factors influencing fibrin structure and fibrin breakdown are addressed; in particular polymorphisms in the genes coding for fibrinogen and FXIII, but also the physical and biochemical conditions in which fibrin is formed.

The past decades have produced a bulk of biochemical publications reviewing fibrin turnover and fibrin structure, and it has been shown that alterations in fibrin structure are important for the development of various disease conditions, whereas, the architecture of fibrin can be modified by certain drugs and chemical compounds. However, these topics deserve increased attention in clinical settings. Of particular importance might be more detailed clinical studies that review the influence of polymorphisms in the genes coding for the key factors involved in fibrin metabolism on the development of hemostatic diseases, but also the role of elastase-induced fibrin degradation deserves increased attention.

KEYWORD

Fibrin - coagulation - fibrinolysis - elastase - plasmin - fibrin structure - factor XIII

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